- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $3,235.94 / $7,943.28
| Facility | | $467.74 | $3,235.94 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $323.59 / $524.81 / $1,380.38
| Professional | | $323.59 | $524.81 | $1,380.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $363.08 / $588.84
| Professional | | $181.97 | $363.08 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $1,698.24 / $1,737.80
| Facility | | $1,698.24 | $1,698.24 | $1,737.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $398.11 / $501.19 / $954.99
| Professional | | $398.11 | $501.19 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $602.56 / $602.56
| Facility | | $602.56 | $602.56 | $602.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $354.81 / $512.86 / $812.83
| Professional | | $354.81 | $512.86 | $812.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $645.65 / $645.65 / $794.33
| Professional | | $645.65 | $645.65 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $467.74 / $741.31
| Facility | | $338.84 | $467.74 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,511.38 / $8,511.38 / $8,511.38
| Facility | | $8,511.38 | $8,511.38 | $8,511.38 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $549.54 / $707.95
| Professional | | $501.19 | $549.54 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $6,918.31 / $10,471.29
| Facility | | $1,659.59 | $6,918.31 | $10,471.29 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $281.84 / $389.05 / $707.95
| Professional | | $281.84 | $389.05 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $4,786.30 / $45,708.82
| Facility | | $4,786.30 | $4,786.30 | $45,708.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $3,019.95
| Professional | | $2,570.40 | $2,570.40 | $3,019.95 |